Biomedical subjects

Anita Cavallo

Publications and source records attributed to Anita Cavallo.

2 recordsLinked to original sources

PubMed2003

The night float paradigm to decrease sleep deprivation: good solution or a new problem?

In the late 1980s physician residency training programs developed the night float rotation, characterized by a sequence of 5 - 15 days of night work without any daytime duties, thereby involving an abrupt reversal of the wake - sleep schedule. We examined the effect of the night float rotation on sleep, mood and performance of pediatric residents. Residents completed sleep diaries daily, and tests of mood (Profile of Mood States) and attention (Conner's Continuous Performance Test) three times a week during the two-week night float rotation, and during equivalent blocks of time of their daytime rotations. Results show that, despite having ample opportunity to sleep during the day, while on night float rotation residents slept less than during the nights of their normal daytime rotations, 6.3 h +/- 2.5 h and 7.2 h +/- 1.7 h, respectively, p < 0.0001. Also, during night float compared to daytime rotations residents had increased fatigue-inertia scores, 8.7 +/- 4.1 and 4.8 +/- 2.4, respectively, p < 0.0001, and decreased vigor-activity scores 10.7 +/- 5.4 and 14.8 +/- 5.3, respectively, p = 0.02. The scores for attention were not significantly different between night float and daytime rotations. The correlation coefficients of fatigue with measures of attention were not statistically significant for daytime rotations. However, for night float fatigue correlated with omission errors, r = 0.51, p = 0.001 and with attentiveness r = - 0.36, p = 0.03. Training programs that adopt the night float rotation must be aware of potential deleterious effects of the night float rotation as they may lead to serious consequences on residents' performance and patients' safety.

Adaptation, Physiological↗

PubMed2002

Impact of night-float rotation on sleep, mood, and alertness: the resident's perception.

Night-float rotations were designed to alleviate the workload of residents on night call and thereby improve patient safety. However, the impact of the night float on residents is yet to be surveyed. We assessed the impact of the night-float rotation on pediatric residents using an anonymous questionnaire that covered topics, based on recall, about sleep, mood, alertness, adjustment, and others. The study was conducted in a major tertiary pediatric teaching hospital in the United States. Participants were pediatric residents who had completed one or two night-float rotations and were in active training at our teaching hospital at the time of the study. Fifty-two of 60 eligible residents (87%) responded. Sleep duration during the night-float rotation was shorter than during day-shift work in 24 residents (46%), longer in 20 (38%), and unchanged in eight (15%). A higher proportion of residents took longer to fall asleep, had more difficulty falling asleep, had more sleep interruptions, and felt less rested upon awakening. Twenty-four residents (46%) felt that their bodies never adjusted to the night shift. Also, 22 residents (43%) felt moody or depressed in contrast to seven (14%) who felt depressed during the daytime rotation (p = 0.0001). Twenty-one residents (41%) felt they were slower in their thinking during the night float than daytime rotations. The results suggest that disturbances of sleep and mood and decreased alertness, typical of night shift, are present in the night-float rotation. Residency programs should monitor closely the impact of the night-float rotation on resident well being and patient safety. The impact of night-shift work should be considered in the design of night-float schedules, and teaching should be provided for residents to learn coping strategies for night-shift work.

Affect↗